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Semester 2-MSK > Session 8-Lumbar Spine Structure, Function And Common Disorders > Flashcards

Session 8-Lumbar Spine Structure, Function And Common Disorders Flashcards

1
Q

How many:

1) cervical
2) thoracic
3) lumbar
4) sacral
5) coccygeal vertebrae are there?

A

1) 7
2) 12
3) 5
4) 5
5) 4

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2
Q

How many separable single vertebrae are there?

A

24

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3
Q

Which are the most mobile areas of the spine?

A

Cervical

Lumbar

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4
Q

Which area of the spine is relatively immobile and why is this?

A

Thoracic

Ribs attached limits movement

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5
Q

Which two parts of the spine are fusions of vertebrae?

A

Sacrum

Coccyx

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6
Q

What are the functions of the vertebral column?

A
  • supports skull, pelvis, upper limbs and thoracic cage
  • protection of spinal cord and cauda equina
  • movement: highly flexible structure of bones, intervertebral discs and ligaments
  • haemopoiesis: red marrow
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7
Q

True or false: vertebral bodies decrease in size inferiorly

A

FALSE - increase in size as compression forces increase

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8
Q

Why are the sacral vertebrae fused, widened and concave anteriorly?

A

To transmit weight of body through pelvis to legs

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9
Q

Which movements does the lumbar spine allow?

A

Flexion and extension
Lateral flexion
Rotation

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10
Q

What is the largest part of the vertebra?

A

Vertebral body

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11
Q

What is the vertebral body made up of?

A

10% cortical bone

90% cancellous bone

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12
Q

What are the advantages of having a higher proportion of cancellous bone in the vertebral body?

A

1) lighter

2) other functions ie haemopoiesis

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13
Q

What are end plates?

A

Articular surfaces covered with hyaline cartilage on superior and inferior parts of vertebral column

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14
Q

What connects transverse process to spinous process?

A

Lamina

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15
Q

What connects transverse process to body?

A

Pedicle

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16
Q

What is the lamina and pedicle called collectively?

A

Vertebral arch

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17
Q

What emerges through intervertebral foramina?

A

Spinal nerves

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18
Q

What is the articulation of superior and inferior articular processes called?

A

Facet joint (synovial)

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19
Q

What does the interlocking design of facet joints prevent?

A

Anterior displacement of vertebrae

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20
Q

What is the composition of intervertebral discs?

A

70% water
20% collagen
10% proteoglycans

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21
Q

Why do we lose height with age?

A

Repair of proteoglycans is less with age so chains get shorter so less hydrophilic and lose water and discs lose height

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22
Q

What is the role of proteoglycans in intervertebral discs?

A

Binds water (hydrophilic)

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23
Q

What are the two regions of intervertebral discs?

A 
Nucleus pulposus (central)
Annulus fibrosus (peripheral)
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24
Q

What is annulus fibrosus made of?

A

Type I collagen

25
Q

What is the major role of annulus fibrosus?

A

Shock absorber

26
Q

True or false: intervertebral discs are avascular

A

TRUE

27
Q

What is the nucleus pulposus a remnant of?

A

Notochord

28
Q

What is nucleus pulposus made of?

A

Type II collagen

29
Q

When are intervertebral discs very strong?

A

Axial compression

30
Q

What do the ligaments of the vertebral column provide?

A

Stability

31
Q

What are the major ligaments of the vertebral column and which is stronger?

A

Anterior longitudinal and posterior longitudinal ligament

Anterior is stronger

32
Q

What is the function of the anterior longitudinal ligament?

A

Prevents hyperextension

33
Q

What does the posterior longitudinal ligament prevent?

A

Hyperflexion

34
Q

What makes ligamentum flavum yellow?

A

Elastic fibres

35
Q

What is the role of ligamentum flavum?

A

Limits hyperflexion

36
Q

What do interspinous ligaments do?

A

Unite spinous processes

37
Q

Where are the supraspinous ligaments?

A

Tips of adjacent spinous processes

38
Q

Describe the curvatures of the vertebral column

A 
Cervical - lordosis (curves backward)
Thoracic - kyphosis (curves forward)
Lumbar - lordosis
Sacral - kyphosis 
Coccyx - kyphosis
39
Q

What is the primary curvature?

A

Curve we’re born with-kyphosis

40
Q

What are the ‘weak points’ of the vertebral column?

A

Where the centre of gravity pass through the vertebral column (C1, C2, C7, T1, T12, L1, L5, S1)

41
Q

Where is there an exaggeration of lordosis during pregnancy?

A

Lumbar region

42
Q

What is mechanical back pain?

A

Pain when spine is loaded

43
Q

When is mechanical back pain:

1) worse
2) relieved?

A

1) exercise

2) rest

44
Q

What are the predisposing factors of mechanical back pain?

A

Overweight
Unhealthy lifestyle
Deconditioned core muscles

45
Q

How does decreased disc height lead to pain?

A

Decreased height -> increased stress on facet joints -> osteoarthritis -> pain

46
Q

What are the four stages to disc herniation?

A

1) degeneration (ageing)
2) prolapse (protrusion of nucleus pulposus into spinal canal)
3) extrusion (nucleus pulposus breaks through annulus fibrosus)
4) sequestration (nucleus pulposus breaks through annulus fibrosus and separates from main body of disc in spinal canal)

47
Q

Where is the most common location of slipped discs?

A

L4/5 or L5/S1

48
Q

What is sciatica?

A

Compression of nerve roots which contribute to sciatic nerve

49
Q

Which nerve roots contribute towards sciatic nerve?

A 
L4
L5
S1
S2
S3
50
Q

What are the types of sciatica?

A

L4 sciatica - anterior thigh, anterior knee and medial shin
L5 sciatica - lateral thigh, lateral calf and dorsum of foot
S1 sciatica - posterior thigh, posterior calf, heel and sole of foot

51
Q

What is cauda equina syndrome?

A

Compression of cauda equina

52
Q

What are the symptoms of cauda equina syndrome?

A

Bilateral sciatica
Perianal numbness
Painless retention of urine
Urinary/foecal incontinence

53
Q

What is lumbar canal stenosis?

A

Narrowing of spinal canal in elderly due to:

  • Disc bulge
  • Arthritis in synovial facet joints
  • Ligamentum flavum expands and restricts space for nerves
54
Q

What is claudication?

A

Pain in legs when walking

55
Q

What is spondylolisthesis?

A

Slip forwards of vertebra above on vertebra below

56
Q

What are the types of spondylolisthesis?

A
  • dysplastic: abnormality in shape of facet joints
  • isthmic: defect in pars interarticularis
  • degenerative
  • iatrogenic
  • pathological (tumours)
57
Q

What does a patient with isthmic spondylolisthesis present with?

A

Back pain and L5 sciatica

58
Q

What does a patient with degenerative spondylolisthesis present with?

A

Claudication

Semester 2-MSK (23 decks)

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